PMT18-04043 City of Menifee Permit No.: PMT18-04043
_ 29714 HAUN RD.
MENIFEE, CA 92586 Type: Residential Electrical
MENIFEE MENIFEE Date Issued: 0 811 512 01 8
PERMIT
Site Address: 29772 COOL MEADOW DR, MENIFEE, Parcel Number: 339-393-007
CA 92584 Construction Cost: $1,900.00
Existing Use: Proposed Use:
Description of DERATE MAIN BREAKER 100A CENTER FEED
Work:
Owner Contractor
JOSEPH URBAN HOSOPO CORPORATION
29772 COOL MEADOW DR 7100 WEST FLORIDA AVE
MENIFEE,CA 92584 HEMET, CA 92545
Applicant Phone:9519261176
HOLLY THOMPSON License Number: 1004233
HOSOPO CORPORATION
7100 WEST FLORIDA AVE
HEMET, CA 92545
Fee Description ON Amount($1
Services, Switchboards, Control Centers&Panels 1 116.00
Building Permit Issuance 1 27.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Electrical 1 5.80
$149.80
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise slated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA Bldg_Pennit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a licensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 70D0)of Division 3 of the Business and 0I am exempt from licensure under the Contractor's State License Law for
Professions Code and my license is in full force and effect. the following reason:
License Class s, C�A(O Licens No. a s('
L3 By my signature below i acknowledge that,except for my personal residence
Expires Gp��o/iU Signature in which I must have resided for at least one year prior to completion of
WORKER'S COMPENSATION DECLARATION improvements covered by this permit.I cannot legally sell a structure that I
have built as an owner-builder if it has not been constructed in its entirety by
D I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for worker's 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which www.Ieginfo.ca.gov/caIaw.htmI.permit is issued. sv
Polity 4 Date O
0I have and will maintain workers compensation insurance,as required by PROPERTY OWNER OR AUTHORIZED AGENT
section 3700 of the Labor Code,for the performance of the work for which 0 By my signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation insurance carrier and policy owner or authorized to act on the property owner's behalf.I have read this
numberare: _ application and the information 1 have provided Is correct.I agree to comply w
Carrier NDi ('�j-I�LI Y/(� � XI'fl ld/�{�/{C.2i with all applicable city and county ordinances and state laws relating to
building co struc[ion.lauthorize representatives of this city or county to
Policy#L'wcic) L',BL:fCcg'7 Expires fir'' Z �(B enter the. ove identi ed property for inspection purposes.
(This section need not to be completed is the permit is for one-hundred
dollars($100)[r less DatePROPBR7Y NE R THORIZEDAGENT
01 certify that in the performance of the work for which this permit is issued, ./
I shall not emnlov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE N
worker's compensation laws of California,and agree that if I should become
subject to the worker's compensation provisions of Section 370D of the Labor HAZARDOUS MATERIAL DECLARATION
Code,I shall forthw h comp y with those provisions. tt l Will the applicant or future building occupant handle hazardous material or a
Applicant / Date I, mixture containing a hazardous material equal to or greater that the
// amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE O'S6 RE WORKER'S COMPENSATION COVERAGE IS ❑Yes 4%
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
IN SECTION ON TO
06 OF
THE OF
CODE,INTEREST,
DAMAGESDATTOR ATTORVIDEDNEYS
FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS FEES forguidelines
CONSTRUCTION LENDING AGENCY o Yes �A No
1 hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) o Yes �*o
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
I hereby affirm under penalty of perjury that I am exempt from the permitting checklist I understand my requirements under the State of
Contractor's License Law for the reason(s)indicated below by the California Health&Safety Code,Section 25505 and 25534 concerning
[heckmark(s)I have placed next to the applicable item(s)(Section 70315 hazardous mater' I reporting.
oyes o Business and Professions Code).Any city or county that requires a permit to (>� Date ) /
construct,alter,improve,demolish or repair any structure,priorto Its PROPERTY(1WNE O•AU'HORIZED AGENT
l(d
issuance,also requires the applicant for the permit to file a signed statement C
that he or she is licensed pursuant to the provisions of the Contractor's State EPA RENOVATION,REPAIR AND PAINTING(RRP)
License Law(Chapter9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from licensure receiving compensation for most work that disturbs paint In a pre-1978
• and the basis for the alleged exemption.Any violation of Section 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
o 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( )all of or( )portion of the work,and the structure is www.eoa.eov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractor's State License Law does not apply to an owner of a ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
property who,through employees'or personal effort,builds or improves the
property provided that the improvements are not intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that It was
not built or improved for the purpose of sale. 0 No EPA Lead-Safe Certified Firm is required for this project because:
o I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State Ucense Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
DATE: 8/15/18 PERMIT/PLAN CHECK NUMBER `
PLANNING CASE NUMBER
TYPE: O COMMERCIAL )O RESIDENTIAL 0 MULTI-FAMILY O MOBILE HOME <% POOL/SPA O SIGN
SUBTYPE: is ADDITION 0 ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING 0 RE-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK Derate 100 CW4-er GIN IGt 9 16e '
PROJECTADDRESS 29772 Cool Meadow Dr ZIP
ASSESSOR'S PARCEL NUMBER LOT TRACT
OWNER NAME Joseph Urban
ADDRESS 29772 Cool Meaow Dr
PHONE EMAIL
APPLICANT NAME Holly Thompson
ADDRESS 7100 W Florida Ave
PHONE 951.537.6859 EMAIL holly.thompson@horizonsolarpower.com
CONTRACTOR'S NAME OWNER BUILDER? OYES 0 NO
BUSINESS NAME Hosopo Corp DBA Horizon Solar Power
ADDRESS 7100 W Florida Ave
PHONE 951-926-1173 EMAIL
CONTRACTOR'S STATE LIC NppU��MBERf'1004233 LICENSE CLASSIFICATION C46, C10, B
VALUATION$ 1' q O U . ()0 SQ FT LSQ FT
APPLICANT'S SIGNATURE DATE 8/15/18
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION ACCEPTED BY: CITY OF MENIFEE BUSINE55 LICENSE NUMBER
BUILDING PLANNING ENGINEERING FIRE
INVOICETOTAL ! O GREEN SMIP
OWNER BUILDER VERIFIED 0 YES O NO DRIVERS LICENSE# NOTARIZED LETTER G YES O NO
City of Menifee Building & Safety Department 129714 Haun Rd., Menifee, CA 92586 (951)672-6777
www.cityofmenifee.us
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